State effort to deny care for 96-year-old blocked

A threat to evict a 96-year-old legally blind woman from the nursing home where she has lived for nearly three years was lifted Tuesday by an order signed in Lenawee County Circuit Court.

The order reverses state government decisions denying Medicaid coverage for Joy Wonders to remain in the Lenawee Medical Care Facility. Administrative law judges ruled three times that Wonders was too healthy for nursing home care paid for by Medicaid, despite being blind and confined to a wheelchair.

Wonders and her family were relieved and happy the nearly 2-year-long legal struggle is over, said attorney Mark Bruggeman of Adrian.

“It was one of those times when you make the telephone call and they thank you a hundred times for sticking with it,” he said.

“I think this is on the right side. If she didn’t qualify, then no one qualified,” Bruggeman said.

Judge Timothy P. Pickard twice sent the case back for further review after Wonders was denied benefits. At a hearing in November, Bruggeman said, an assistant Michigan Attorney General was told, “in Lenawee County we don’t mistreat our elders.”

Rather than returning to defend a third decision in Lansing denying Wonders nursing home care, Bruggeman said assistant Attorney General William Morris agreed to an order for Medicaid coverage.

Bruggeman said it was frustrating that the Michigan Department of Human Services and state officials would not accept that Wonders’ physical condition should qualify her for care.

“There is no question that Mrs. Wonders, as a 94-year-old woman in a wheelchair with poor balance, unstable gait and a fall risk should be considered frail,” Bruggeman stated in a 2012 court brief. Being legally blind, he argued, she could not be expected to manage the 15 different medications she is taking.

A Jan. 31 decision by administrative law judge Robert Meade stated he could not waiver from “established department policy.” He ruled that Wonders was not qualified for nursing facility care because she is being successfully treated for severe spinal pain. Evidence showed she is in pain only a few days or a week each month between monthly steroid injections to her spine, he stated, so “it simply cannot be said that appellant is in consistent and debilitating pain.”

Bruggeman said Wonders entered the Lenawee Medical Care Facility on June 1, 2011, on the advice of her doctors. She was able to pay $220 per day for her care until her assets ran out within a year.

If she had not received Medicaid coverage, he said, she could have been forced to leave the facility and her family billed $147,000 for her care since May 2012.